Related Experiment Video
Updated: Jun 12, 2025
A Rat Model of Ventricular Fibrillation and Resuscitation by Conventional Closed-chest Technique
Published on: April 26, 2015
Outcomes and Resource Utilization in Hyperkalemic Emergency Department Patients Treated With Patiromer or Sodium
William Frank Peacock1, Zubaid Rafique1, Julie Gayle2
1Department of Emergency Medicine, Baylor College of Medicine, Houston, Texas, USA.
Insights
In emergency departments, patiromer showed lower in-hospital mortality for hyperkalemia patients, while sodium zirconium cyclosilicate (SZC) was linked to reduced 30-day hospitalizations. Both potassium binders had similar discharge outcomes.
Area of Science:
- Nephrology
- Emergency Medicine
- Pharmacology
Background:
- Hyperkalemia (HK) is a critical condition often managed in emergency departments (ED).
- Real-world data on potassium binder effectiveness in the ED setting is scarce.
- Patiromer and sodium zirconium cyclosilicate (SZC) are key treatments for hyperkalemia.
Purpose of the Study:
- To compare ED discharge disposition and resource utilization between patiromer and SZC in hyperkalemia patients.
- To evaluate real-world outcomes of potassium binder administration in the emergency department.
- To analyze in-hospital mortality and 30-day rehospitalization rates for patiromer versus SZC.
Main Methods:
- Retrospective cohort study utilizing the Premier PINC AI Healthcare Database (230 hospitals).
- Inclusion criteria: patients ≥18 years, potassium ≥5 mEq/L, treated with patiromer or SZC from January 2019 to December 2021.
- Multivariable logistic regression analysis to compare outcomes between patiromer and SZC cohorts.
Main Results:
- A total of 18,248 patients were analyzed (6480 patiromer, 11,768 SZC).
- Patiromer users were older, more likely White/Hispanic, with Medicare, and higher comorbidity scores.
- Adjusted analysis revealed similar inpatient admission rates (aOR=1.09). Patiromer use was associated with lower in-hospital mortality (aOR=0.85) but higher 30-day all-cause (aOR=3.54) and hyperkalemia-related hospitalization (aOR=3.28) risks compared to SZC.
Conclusions:
- Patiromer and SZC demonstrated comparable ED discharge dispositions (inpatient ward/home).
- Patiromer use was associated with decreased in-hospital mortality.
- SZC use was linked to reduced 30-day all-cause and hyperkalemia-related hospitalizations.
Objectives:
Hyperkalemia (HK) is a life-threatening condition commonly treated in emergency department (ED). Real-world outcomes associated with ED administration of potassium binders are limited. This study assessed ED discharge disposition and resource utilization in hyperkalemic ED patients treated with patiromer or sodium zirconium cyclosilicate (SZC).
Methods:
We performed a retrospective cohort study using discharge data from 230 hospitals in the Premier PINC AI Healthcare Database. ED patients were included if they were ≥18 years old, had potassium ≥5 mEq/L, and received patiromer/SZC during January 1, 2019 to December 31, 2021. Descriptive statistics and multivariable logistic regression analysis were used to compare outcomes between binder cohorts.
Results:
Of 18,248 patients meeting selection criteria, 6480 and 11,768 received patiromer and SZC, respectively. Compared with patients receiving SZC, patients receiving patiromer were older, more likely to be White and Hispanic, with Medicare as primary insurance, and had a higher mean Charlson-Deyo Comorbidity Index. Adjusted analysis showed that the odds of being admitted to an inpatient ward were similar between cohorts (adjusted odds ratio [aOR] = 1.09; 95% CI: 0.96, 1.23). Patients receiving patiromer had lower mortality during index visit (12.0% vs 16.3%; aOR = 0.85; 95% CI: 0.76, 0.95), but higher odds of all-cause hospitalization (3.0% vs 0.8%; aOR = 3.54; 95% CI: 2.73, 4.59) and hyperkalemia-related hospitalization (1.1% vs 0.3%; aOR = 3.28; 95% CI: 2.15, 5.00) during 30-day follow-up than patients receiving SZC.
Conclusion:
This large nationally representative sample of US ED patients showed that patiromer and SZC treatment had similar discharge dispositions to inpatient ward/home. Patients receiving patiromer had lower in-hospital mortality. Patients receiving SZC had lower 30-day all-cause and hyperkalemia-related hospitalization risks.
More Related Videos
Related Concept Videos
01:20Acute Kidney Injury V: Interprofessional Care
01:28Antihypertensive Drugs: Potassium-Sparing Diuretics
01:22Heart Failure Drugs: Diuretics
01:22Acute Kidney Injury VI: Nursing Management
01:28Chronic Kidney Disease III: Interprofessional Care
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System